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Birth control encompasses a range of tactics, devices, medications, practices, and procedures designed to deliberately prevent or reduce the likelihood of pregnancy or childbirth. During the twentieth century, motivation for birth control ranged from individual choice to concern about increasing populations. In the twenty-first century birth control is seen as the responsibility of both sexually active men and women.

The history of birth control enables us to understand the global reverberations of an agenda for wider dissemination of contraceptive information that began in the in the early twentieth century. For most part, advocates of birth control in countries such as India, Japan, South Africa, Canada, Great Britain, and the United States came from privileged social, cultural, and economic backgrounds. Advocates of birth control found eugenic, Malthusian, and demographic arguments most compelling in making a case for national and international support for birth control and contraception. Some advocates also linked the demand for birth control to improved maternal health and national well-being.

No history is complete without a set of historical actors; important participants in the debates on birth control dating from the 1920s onwards included such players as Mary Burgess, Kamaladevi Chattopadhyay, Raghnunath Dhondo Karve, A. R. Kaufman, Edith How-Martyn, Eileen Palmer, Narayan Sitaram Phadke, Aliyappin Padmanabha Pillay, Margaret Sanger, Ursala Scott, Kato Shidzue, Marie Stopes, and Elsa Woodrow. As the above list—which does not purport to be complete—suggests, far from being a solely Western phenomenon, the demand for birth control was a complex intercontinental movement, with an active cohort that supported and sometimes competed with one another’s work across national boundaries. This cohort of activists collectively created a global propaganda effort to gain acceptance for their controversial demand both within and beyond their nations.

Domestic resistance and political realities made it important for many advocates to seek a larger global platform to win support for their cause. For instance, international prominence and recognition greatly facilitated the work of Margaret Sanger, a U.S. activist, since she faced strong opposition against birth control in the United States due to the Comstock Act (1871), which forbade any dissemination of contraceptive knowledge through the postal system. A similar law banning birth control was passed in Canada in 1892 and was not repealed until 1969. There were no legal bans imposed on birth control in India, Japan, or Great Britain during this time.

International Conferences and Publications on Birth Control

The early advocates of birth control worked on a global platform and were in dialogue with one another from as early as the 1920s, exchanging and borrowing ideas. Their modes of intellectual exchange included organizing international conferences such as the International Birth Control Conference, held in London in 1922 and in New York in 1925. Indian advocates such as Gopaljee Ahluwalia attended both these conferences, as did many other participants from across the globe. Another large population conference was organized in India in 1936; Sanger was among those invited.

The early advocates also published journals that became important intellectual sites for international exchange and discussion on the subject of contraception and birth control. Some of the important journals published from London, New York, Madras, and Bombay (now Mumbai) in the 1920s and 1930s were Birth Control News (United States), Birth Control Review (United States), Madras Birth Control Bulletin (India), and Marriage Hygiene (India). Again, this is not a comprehensive list, but one that points to the rich international variety of publication on the subject. Advocates solicited articles for these journals internationally, and many of these journals carried specific information on birth control work and clinics around the world.

Birth control advocates also published a large number of monographs and books on the subject, which circulated globally. Books by Sanger and Marie Stopes (a British activist) were read by birth control advocates in India, South Africa, Japan, Britain, and United States. Besides being read by a large body of birth control advocates, these books were also read by lay people seeking to control their own fertility. Many private individuals in India and South Africa who read books by Sanger and Stopes wrote to them asking for further clarification on the methods discussed in their books. Stopes’s Married Love and Wise Parenthood: The Treatise on Birth Control for Married People, both published in 1918, circulated widely in South Africa and other parts of the British Empire. Sanger’s books Motherhood in Bondage and The New Motherhood were popular around the world. International birth control activists also endorsed one another’s books; Sanger, for instance, wrote a foreword for Narayan Sitaram Phadke’s 1927 Sex Problem in India, which gave this book greater credibility in the eyes of domestic readers in colonial India.

Financial and Technological Support of Birth Control

Birth control activists sought financial support for their work from donors across the globe. Stopes, for instance, wrote letters to Indian princes in 1927 asking them to support her clinical work in London, while the Indian advocate Aliyappin Padmanabha Pillay requested financial help from the London Eugenic Society to continue the publication of his journal Marriage Hygiene. Sanger wrote to C. P. Blacker, of the London Eugenic Society, to request funds for her India visit in 1935. Sanger’s visit to Japan in 1922 was financed by the Japanese magazine Reconstruction. For her part, Kato Shidzue, a Japanese birth control advocate, went to the United States in 1937 to raise money for her work in Japan. She toured in the United States speaking about birth control.

Besides financial networks that crossed national boundaries, reproductive technologies were also transported globally. Stopes supplied contraceptives to South Africans in the 1930s. Stopes’s Society for Constructive Birth Control and Racial Progress (SCBC) offered to train birth control activists from India and South Africa. Many advocates also visited Sanger in the United States hoping to gain technical training on the subject. Elsa Woodrow, from the Cape Town Mother’s Clinic Committee in South Africa, contacted Stopes in 1931, seeking advice on how to set up a clinic and the costs associated with it. Her organization associated itself with the SCBC and ordered contraceptive supplies from Stopes. The Mother’s Welfare Society of South Africa received financial support from Stopes in 1938–1939. On her various visits to India, Sanger and her assistant Edith How-Martyn carried contraceptive technology with them, which they distributed to the various clinics in India. They also presented advocates with gynecological plaques, which were used by doctors and advocate to demonstrate the use of different contraceptive methods.

Discursive Parameters of Birth Control

Early advocates of birth control drew upon a range of intellectual ideas to make a strong case for the dissemination of contraceptive information. Many advocates found it beneficial to deploy a numerical argument, relying heavily upon census figures that were increasingly becoming available in most countries during the early twentieth century. For instance, the colonial census of 1931 in India revealed a sharp rise in population. This data was used to promote a Malthusian argument for birth control as a remedy for controlling spiraling demographic growth. Nationalist advocates of birth control were also quick to draw a connection between national poverty and size of the nation’s population. None of the early advocates of birth control called for resource redistribution to alleviate national poverty, however. Interestingly enough, Mohandas Gandhi, who strongly opposed the use of any chemical and mechanical contraceptive device, appears to have been one of the first to call for resource redistribution as a solution to India’s growing population problem. He was strongly opposed to birth control on moral and philosophical grounds, and debated with Sanger on the subject in 1936.

Indian feminists such as Kamala-devi Chattopadhyay joined Sanger and Stopes in making a case for birth control as a means of improving women’s maternal health. Lower maternal and infant mortality figures, it was argued, were important indicators of national well-being. Birth control activists also argued that lower fertility figures were a sign of modernity, especially for non-Western nations, which were seen to have higher fertility figures than Western nations such as France and Canada. Fertility figures in France and Canada had been declining from the late nineteenth century onwards, which led to a strong opposition to birth control in those countries.

Tension between Rhetoric and Technology

Examining the writings of the various advocates of birth control might leave one with the impression that they had something concrete to offer in terms of contraceptive technology. On closer examination, however, it seems that the international birth control movement was long on rhetoric but short on technology, especially before the invention and testing of the contraceptive pill in 1960.

In the period between 1930 and 1950 birth control activists greatly differed among themselves about the most appropriate contraceptive technology. Sanger and Lydia DeVilbiss were promoting a spermicidal douche powder that had been tested in Britain. The powder was in use in some of the southern states in the United States. It was marketed in India too. There were complaints against the powder, however; in India women complained about vaginal irritation and also about the difficulty in using this method given the lack of privacy in their working-class homes. In the face of these complaints, Pillay recommended condoms as the most reliable form of contraceptive. Stopes, in the meantime, claimed that she had discovered the ideal method for working-class women of London and for poor women in India and South Africa. The method Stopes was promoting was a cotton waste pessary dipped in olive oil. This method was not endorsed by Indian doctors and advocates.

In India, practitioners of Ayurveda, a traditional Indian system of medicine, advertised their products in vernacular magazines such as Madhuri and Sudha in the 1930s, while biomedical journals such as The Indian Medical Gazette carried advertisements for various commercially marketed contraceptives. Most of these advertisements provided addresses of local chemists who carried these products, but some advertisements in Indian medical journals gave only a London address, which indicates that birth control technologies circulated globally and that consumers shopped in a global market. But it should also be pointed out that consumers of these global products, especially in countries such as India, were primarily members of social and economic elites who could afford to pay for the product and its international postage cost.

Counter-Histories of Birth Control

In the late twentieth and early twenty-first centuries, scholars shifted their focus away from celebrating the work of birth control pioneers and have begun examining how this work was experienced by less powerful social and economic groups in different countries. Native American groups in the United States have spoken out against contraceptive technologies, which they argue have been used to police their sexuality rather than to empower native women to make informed reproductive choices. The history of the birth control movement in India has bought to light the call of the Indian feminist leader Begum Hamid Ali for the sterilization of the “unfit” in her enthusiasm for controlling India’s population. Likewise Puerto Rican scholars tell a sad history of Puerto Rican women who, without knowing and without giving consent, became the guinea pigs used for testing the contraceptive pill in the 1950s. And there are at least two sides to the story following the more widespread and regulated introduction of the pill in the early 1960s. For some it is regarded as one of the more significant medical achievements of the twentieth century. Oral contraception is thought of as playing a significant role in the women’s liberation movement, particularly in regard to the sixties’ era of greater sexual freedom. At the same time the pill brought with it considerable controversy in respect to side effects and ongoing health concerns and, no less significantly, debates surrounding sexual promiscuity and teenagers taking the pill. These revisionist histories force us to examine the real human costs that underwrote the efforts to manage human fecundity.

Future Agenda for Reproductive Health

Feminist scholars working on reproductive health issues are constantly asking themselves what the future agenda for reproductive health should look like. Feminist researchers, policy makers, and activists all agree that the success of contraceptive technology in the future will lie in democratic approaches, attentive to local needs and beliefs, seeking to empower women in making informed choices.

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